In the Lyme world, these stories surface again and again. A child who was thriving suddenly shifts—mood swings, anxiety, trouble focusing, even hallucinations. This might follow a known tick bite. Other times, it just seems to come out of nowhere.

Parents start searching for answers, and more often than not, they’re handed a psychiatric label—bipolar disorder, psychosis, schizophrenia, maybe even oppositional defiant disorder.

Medications are prescribed, therapy is recommended, and that’s usually where the investigation ends. Too often, no one stops to ask what might be driving these symptoms in the first place. The possibility of an underlying infection—something that could be identified and treated—is rarely even on the radar.

A recent study published in Frontiers in Child and Adolescent Psychiatry offers a compelling reason to look deeper.

Led by psychiatrist Rosalie Greenberg, the study examined the medical charts of 37 children and adolescents—ages 9 to 17—diagnosed with pediatric bipolar disorder in a Lyme-endemic region of New Jersey.

Strikingly, 92% of these patients (34 out of 37) showed evidence of tick-borne disease exposure.

Here’s what the study found:

• Babesia was detected in 51% (19 out of 37)
• Bartonella in 49% (18 out of 37)
• Mycoplasma pneumoniae in 38% (14 out of 37)
• Borrelia burgdorferi (the Lyme disease bacterium) in 22% (8 out of 37)
• Group A Streptococcus in 19% (7 out of 37)

Furthermore, 30 of the 37 children—about 8 out of 10—had both lab test results and symptoms that pointed to infection.

Many of the children had multiple infections, and most showed symptoms consistent with PANS/PANDAS—a set of conditions known to cause abrupt psychiatric changes following infection.

Why this matters

This study backs up what many parents and doctors have suspected for years: infections might be part of what’s causing or worsening mental health symptoms in kids. It raises important questions, like:

• Should doctors check for infections when kids show serious psychiatric symptoms?
• Could antibiotics or anti-inflammatory treatments help improve mental health?
• How do things like immune system problems or brain inflammation affect mood and behavior?

The study doesn’t say infections are the cause—but it does show they’re worth looking into, especially when kids aren’t getting better with standard treatments. We need more research, better testing, and doctors who are willing to ask: Could an infection be part of what’s going on here?

We owe it to our kids to look beyond the surface. Because our children’s futures are worth it.

Click here to read the study.

Click here for more information about Dr. Rosalie Greenberg.

TOUCHED BY LYME is written by Dorothy Kupcha Leland, President of LymeDisease.org. She is co-author of Finding Resilience: A Teen’s Journey Through Lyme Disease and of When Your Child Has Lyme Disease: A Parent’s Survival Guide. Contact her at dleland@lymedisease.org.